Organization
CLINICAL WEIGHT LOSS & WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JEANNIE MARIE LEITAO RD, CDE, CDN (OWNER/CEO)
(860) 430-9922
Entity
Organization
Contact information
Practice address
2790 MAIN ST, GLASTONBURY, CT 06033-2027
(860) 430-9922
(860) 633-9922
Mailing address
2790 MAIN ST, GLASTONBURY, CT 06033-2027
(860) 430-9922
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
03/11/2019
Last updated
10/02/2020
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